Product Review: Using a Compex EMS for Recovery, Strengthening, and Injuries

For years and years, I’ve used and loved my Compex electrical muscle stimulators (EMS). I use it primarily when I get injured and when I need some intense recovery that I think is somewhat comparable to a massage. Here’s why I think they belong in every age group athlete’s bag of tricks.

What the Heck is EMS?

If you’re a moderately active multisport athlete, you’ve probably seen the ads from Hammer Nutrition, the importer and distributer of Compex EMS devices in the United States. Reading the ads, you would think that this little device can take a sedentary, overweight smoker off the couch and onto the Podium at Kona in no time. Compex devices are great. Just not that great.

EMS has been around since the 1950s and was heavily researched and popularized in the Eastern Bloc during the Cold War. Since then, EMS has gotten a terrible reputation with cheaply made devices that promise six-pack abs. Quality EMS devices are an entirely different animal. Currently, there are three big names in this field: Compex, Globus, and Marc Pro. All of them use a square-shaped waveform (Marc Pro makes some proprietary variations on it) which ends up being generally much more tolerable than other waveforms.

The basic idea is to trigger muscles to fire directly with an electrical impulse. While this might sound like it has all the appeal of a good session of water boarding, it’s generally not painful. It is a little odd watching parts of your muscle twitch uncontrollably, but the novelty wears off fast. Rather than litter the Internet with yet another video of an EMS device in action, here is something more pertinent than any video I could post– it’s a video of an actual age grouper using a Globus EMS device after a triathlon. Nope, this guy isn’t nervously twitching his legs– it’s the EMS device that is electrically forcing his legs to move that way.

Recovery with EMS

The guy in the video above is using a recovery setting in a Globus EMS device. This causes a very gentle pulse that kind of feels like a massage. All of the manufacturers (Compex, Globus, and Marc Pro) have this setting– in fact this is the only setting in the Marc Pro. This is also the setting that 99% of triathletes, runners, and cyclists gravitate towards and is easily the most important feature of these products.

So what is EMS recovery like? I compare it to a massage insofar as both feel great and are easily the best thing that you can do for your tired aching legs. While massage is unquestionably “deeper” in its effects, it can also leave your legs feeling a bit rubbery afterwards. Not so with EMS– you just feel great with nice bouncy legs that want to tear up the road. I mentioned before seeing Chrissie Wellington at Ragnar on another team– and also noticed she had Compex electrodes on her calves every moment she wasn’t running. It was clear that each time she wasn’t running a leg, she was using EMS to recovery and keep her legs fresh for the next running leg.

I find that the best protocol is to use EMS on my quads and calves simultaneously because these are the muscles that really take a beating on my aged body. I don’t use the traditional pad placements recommended by Compex– instead, I have found a much more efficient set of pad placements described below. Sometimes, I’ll repeat the recovery routine (which takes only about 23 minutes) several times if my legs are really trashed.

Strength Training with EMS

A couple of notes about EMS. First, because EMS bypasses the central nervous system, it fires muscles somewhat randomly. This means that a lot of the muscle fibers that you don’t use get twitchy along with the one that you do use. This fact has some obvious benefits, such as encouraging greater activation of muscles (see below). Second, by playing with the frequency of the signal, EMS manufacturers can target different types of muscle fibers. For instance, low frequencies tend to trigger slow-twitch fibers while high frequencies tend to trigger fast twitch muscle fibers. This has some interesting applications, such as strength building and the possibility of conversion of fast-twitch muscles into slow twitch muscles. Globus and Compex include a bunch of strength training programs that you can use, which I’ll touch on next. Third, because EMS fires a bunch of muscle fibers that aren’t ordinarily fired, using an EMS quickly reveals muscles that you never thought you had. If you’ve never thought you had great muscle definition, using a high setting on an EMS will change that perspective because your muscles will look utterly ripped. It’s almost scary the first time you see it– and it explains why EMS is very popular in the bodybuilding and strength training circles.

While you can use EMS to strength train just about any part of your body (yes, including your six-pack abs), there are really just two situations where I find it extremely useful to rely on EMS for strength training.

Difficult to Train Muscles. There are some muscles that are just darn tough to isolate and train effectively. Picking one muscle somewhat randomly, the abductor hallucis muscle pulls your big toe out sideways away from the rest of your foot. It also has a big role to play in controlling your big toe and your arch. But it’s not exactly a muscle that you can strengthen, however, with a dumbbell and a series of drop sets. While you can do isometric exercises for it, EMS is a great way to exercise it. Also, while I can’t find any research to back this up, I’m fairly confident that regular stimulation with EMS can make it easier to find and isolate that muscle. A related way to use EMS is for muscles that might be easy to isolate but where exercising them may cause collateral damage. For instance, I once had an ankle injury but had to exercise my soleus muscles. EMS worked great to help train it without compromising my ankles with bent knee calf raises.

Burn-Proof Quads. We all know that feeling where your quads feel like they are on fire climbing a steep hill. Spend a few weeks with a Compex or Globus EMS in “endurance mode” on those quads and I bet that you won’t have that problem in the future. Of course, you’ll quickly find a second limiter (your lungs) stifling your efforts, but at least your legs won’t give you any trouble.

Another way that some people use strength training EMS programs is while they are going through an exercise motion. The central nervous system does a really good job at preventing all of our muscle fibers from firing– in fact, even when we’re sprinting, we only use a fraction of our muscles. This partially explains those stories of tiny moms suddenly able to lift a car off their babies– we have a lot of “muscle reserve” that we very rarely use. But what if we could use more of that reserve on an more regular basis– such as when we’re racing against an 18 year old? This is where EMS comes in. It’s well known that a nerve and muscle that get stimulated a lot are a lot easier to stimulate in the future. And because EMS stimulates a nerve fiber and muscle indiscriminately, a lot of those muscle fibers in our “muscle reserve” are getting fired. Combine that with the voluntary movement of, say, pedaling a bike on a trainer, and the body will be fooled into firing those same sleeper muscle fibers as part of the normal pedaling motion. Voila! Instant speed! Unfortunately, I’ve not played around this idea too much yet.

As useful as these EMS strength training strategies are, however, I tend to not use the strength training EMS protocols (with the exception of “Difficult to Train Muscles”) that much. Why? Well, they tend to trash my legs for running. In the pre-season, this might not be such a big deal as running fast and gracefully for long periods is not the purpose of this phase of training– but it is a big deal any other time of the year.

As we all know, the secrets to injury treatment are two-fold. First, we want to reduce unnecessary inflammation. Some inflammation is absolutely necessary, but the body tends to overreact. A lot of that swelling is often lymph that linger around too long. Second, we want to encourage good circulation, which brings in all the good healing stuff for our injuries. EMS on a recovery setting is absolutely fantastic for both of these tasks. This isn’t something that Compex or Globus really promote– but it is the mainstay of the Marc Pro product.

The theory isn’t explained in the Marc Pro product literature directly. Instead, you have to pick up a copy of Iced! The Illusory Treatment Option by Gary Reinl (with a foreword by legendary cross fit God, Kelly Starrett). In it, Mr. Reinl attacks the RICE (rest, ice, compression, elevation) protocol with a vengeance– pointing out that ice has zero effect on injury healing and actually slows the healing process. Instead, the answer is muscle activation and lymphatic drainage– which can either be accomplished by hours and hours of gentle movement or by simply hooking up (yes, you guessed it) a Marc Pro device. It also just so happens that Mr. Reinl is a marketing consultant for the Marc Pro.

Despite the obvious conflict of interest presented by Mr. Reinl, the logic is sound. This is one of those instances where we have to accept the message despite the dubious background of the messenger. There are plenty of examples of athletes using EMS to treat their injuries like this. Joe Arnone talks about it in his book, The Complete Compex Guide. And Mr. Reinl’s book often almost reads like a testimonial blog with stories of athletes who used an EMS to make miraculous recoveries in no time. In my case, I just put one electrode directly on top of the source of my pain and another on a my opposite leg in the same location and let it very gently twitch away for 5 hours a day and, by race day, I was “cured” (or at least healed enough to race hard).

A Few Thoughts on Pad Placement

I actually bought and used a Marc Pro for about a month this summer. While I ended up returning it (more on that later), I learned a ton of information from my experience. First, Marc Pro recommends an entirely different pad placement that I think is utterly invaluable for any Compex or Globus user to learn about. The picture at the left shows how the Marc Pro does it– just one lead (with two wires) going to each muscle of the quadriceps with the pads being placed roughly in the middle of the vastus medialis oblique (VMO) and another placed in the middle of the rectus femoris. By contrast, the picture on the right shows the Compex method. The Compex pad placement requires two wires (and four leads) to accomplish the same task with one wire being grounded at the insertion point of the muscle. For my calves, I use the Compex pad placements minus the grounding pad. In other words, I put one electrode over the medial gastrocnemius head and its paired electrode over the lateral gastrocnemius head. Two leads takes care of both calves this way.

Another lesson that I learned was how to use lymph gland locations with an EMS to effectively “flush” out a entire leg quickly and easily. If you are using a Compex or Globus device for recovery, I’d recommend taking a look at the Marc Pro User Manual and at the Marc Pro page with videos on pad placement, which describes all of this information in much greater detail.

Choosing an EMS Device

While the Marc Pro is an excellent device that seems to be used by just about every professional sports team in the country, I returned mine for two basic reasons. First, it has only two sets of leads. As shown in the photo above, this means that, even with Marc Pro’s highly efficient lead placement, I can only recover my quads, then move to my calves– which doubles my time. If I used this same pad placement on a Compex (which has four sets of leads), I can do both my quads and calves at the same time. Second, the signal strength on the Marc Pro isn’t very strong so even if I split the leads (to help more parts of my body recover simultaneously), it wouldn’t be able to create enough of a “twitch” to be effective.

Choosing between the Compex and the Globus devices is like choosing between chocolate and vanilla ice cream– it’s really a matter of personal preference. Globus units tend to be bigger, less expensive, and have more programs to select from. They also use wire “pin” leads. Compex units tend to be smaller, more expensive, and usually more limited in their program selection. Except for the first generation unit (the blue and gray one in the first photo), Compex EMS units use proprietary “snap” leads (although there is a set of retrofit wires that allow you to convert the older models to the new snap leads). I find the snap leads to be far more convenient to use, but Compex’s EMS pads costs a lot more. In a later post, I’ll talk about how to retrofit your Compex to avoid this up charge. At the end of the day, I like the Compex devices, but that’s just a personal preference– I’m sure I’d be satisfied using a Globus.

Summing Up

One thing is for sure. A quality EMS device is one of the best things you can do for recovering– and beating the pants off your younger competitors. Using EMS for recovery erases the age difference and I probably feel fresher than I did when I was 18 years old. Plus, EMS is probably the best thing you can do for injuries and enables you to bounce back from most injuries better than an 18 year old. This is a case where being older and smarter beats being younger and stronger.

Sorry about the long delay. I took an extended break from blogging. No real thoughts on which unit is better but I’d say that the recovery function on any unit is at least 80% of the value for most endurance athletes I know.

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